Lifting all boats: strategies to promote equitable bidirectional research training opportunities to enhance global health reciprocal innovation.

Inequities in global health research are well documented. For example, training opportunities for US investigators to conduct research in low-income and middle-income countries (LMIC) have exceeded opportunities for LMIC investigators to train and conduct research in high-income countries. Reciprocal innovation addresses these inequities through collaborative research across diverse global settings.The Fogarty International Center of the US National Institutes of Health (NIH) promotes research capacity building in LMICs. Fogarty K-grants for mentored career development in global health are available for both US and LMIC investigators, whereas the D43 is the standard grant to support institutional training programmes in LMIC. Other NIH institutes fund T32 training grants to support biomedical research training in the USA, but very few have any global health component. Most global health training partnerships have historically focused on research conducted solely in LMIC, with few examples of bidirectional training partnerships. Opportunities may exist to promote global health reciprocal innovation (GHRI) research by twinning K-awardees in the USA with those from LMIC or by intentionally creating partnerships between T32 and D43 training programmes.To sustain independent careers in GHRI research, trainees must be supported through the path to independence known as the K (mentored grantee)-to-R (independent grantee) transition. Opportunities to support this transition include comentorship, research training at both LMIC and US institutions and protected time and resources for research. Other opportunities for sustainability include postdoctoral training before and after the K-award period, absorption of trained researchers into home institutions, South-South training initiatives and innovations to mitigate brain drain.

Maternal health in India: A survey of birth attendant competency through completeness of prescribed care during perinatal visits, in 12 randomly chosen districts of Uttar Pradesh, India.

We assessed the completeness of care provided during perinatal visits at public institutions in Uttar Pradesh (UP), India. Self-reported data from 53 interviews with birth attendants throughout 12 districts in UP showed that 52% of the items from a procedural checklist were covered during visits. Routine visits were found to be incomplete, provider training related to pharmaceuticals and counseling were suggested to be low, and the monitoring of vitals to be infrequent and inconsistent. We suggest further grassroots research be conducted in developing nations so that strategic and precise reform can be made to lower global maternal mortality.